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1104439975
SHANAVIA NATAE DICKERSON
JONESBORO, GA
NPI
1104439975
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: GA MT012487)
Enumeration Date
2020-08-31
Last Update Date
2020-08-31
Business Address
SHANAVIA NATAE DICKERSON
1731 TILDEN AVE
JONESBORO, GA 30236-3744
Phone number: 470-549-5131
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Mailing Address
SHANAVIA NATAE DICKERSON
1731 TILDEN AVE
JONESBORO, GA 30236-3744
Phone number: 470-549-5131
Copy
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